Where to go?

I don't believe your chances of ridding yourself of atrial fibrillation is only 50% just due to your age and that you have a (formal?) diagnosis of persistent AF. In the right hands, with the rights skills and experience, you might find yourself a lot more optimistic. Think of Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin, or Dr. Pasquale Santangli at Cleveland Clinic. There are others, I'm sure, but they are the two I have heard of who are real crackerjacks in the EP field (I live in Canada, but I spend a bit of time on fora dealing with AF).

I am 79 and I have been diagnosed with A-fib since last October, about 9 months. I had a cardioversion on 12/4/2014. I was very anxious after this but it was successful until May, 2025 when I had 3 episodes about a week apart lasting a few hours before it resolved. I have made every "lifestyle" adjustment that I can make, short of changing my age! I was ready for an ablation after I took a vacation overseas. My husband had an accident abroad and we were not able to fly home for 20 days after our tour ended. During that time, I had every stress under the sun--and no decaf available, drank some wine, walked miles in the heat to grocery store, laundromat, hospital, pharmacy, hotel--worried about where to stay, how to get home, pay bills, keep husband positive--and I never had a single missed beat! Go figure! I thought I wanted an ablation before I left and now I am not sure. I don't think age has anything to do with this. I don't think statistics have anything to do with it--50% or 80%. It is a quality of life thing for me. I hate the feeling of the arrhythmia and I can't tolerate the way it limits what I want to do. My cardiologist also tells me that A-fib "won't kill me" but it also does not make the life I have left very pleasant. It is your decision but I would not rule out discussion with a good electrophysiologist (I was referred to one who is wonderful) and the latest procedures available to give you a more realistic picture of what your choices can be. Good luck!

I totally agree with your statements.

Totally agree

I am 76 and rarely feel afib maybe a minute or two. But I learned to abstain from caffeine, coffee, dark chocolate, mountain dew, colas. If you are eating or drinking anything with caffeine, stop, and watch what happens. Also, low sugar diet and drink water.

I have, for the most part, done what you have stated above. I have made a concerted effort to cut sugar out of my diet and I haven't drank pop in years. I don't eat fast food and I rarely eat red meat or pork. I haven't given up on my coffee but I only drink one cup a day and that is probably the only caffeine I have all day. I try to drink at least 48 ounces of water a day. I still like to have a couple of beers on the weekend but rarely more than 4 at any given time. I walk for 20 minutes every morning and do a weight workout 3X a week. I honestly don't notice my Afib probably because it is constant and I have just gotten used to it. I am open to looking into other options, as long as they don't involve prescription medication. I take a blood thinner but I am not going to go on pill regimen. I watched my parents go through that and I swore I would not go down the same path.

The same path for long-standing persistent AF, or for permanent AF, is possible mitral valve failure and heart failure (cardiac insufficiency is a much more accurate term, but it means the heart loses a lot of efficiency in pumping due to vessel wall thickening, at which they lose volume AND become much stiffer against their own intended function).

BTW, in case you aren't aware of it, in order to get off meds, you do need to be free of arrhythmia. Ablations do a great job of doing that for you. But there is still the bit of risk, a higher risk, of stroke due to dislodging clots from the left atrial appendage. In recent years, many EPs recommend the insertion of a device called a Watchman into the LAA. Inside of about 15 weeks the Watchman should be sealed off with endothelial tissue, thus closing off the LAA and preventing either leaking from it or blood from entering it. If a trans-esophageal echo cardiogram at the six month mark shows no leakage, many/most EPs will advise that you can now cease the anti-coagulant. (Note: if you have other risks for stroke, your physicians would recommend you stay on an anti-coagulant for life. Please google 'CHA2DS2-VASc score', and you'll find an explanation of this calculus that physicians use to determine your whole-body risk of stroke and if you need a prophylaxis. Some sites have a calculator that you can use to fill in your own data and derive your own score...if you're scrupulously honest about the inputs).

I think it is hard to do something when our parents went through it and it didn't work, especially the heart. I caution you though much has changed in the heart arena and it continues to change. I should know, lifelong heart patient, RN, and critical care Cardiac nursing. Meds do not all work the same. They don't work the same on different individuals but
Might help convert your afib and keep you out of afib and feel better. Try get facts keep an open mind and i hope you can get out of afib🙂

I am glad that all those lifestyle changes have worked for you. As I said in my comments, I did all of that too; I lost weight, gave up all alcohol and switched to limited amounts of decaf coffee. I never drank any sugary sodas or ate super salty, heavy meals. I exercise every single day. But when we were grounded in France after my husband's injury, I drank regular coffee because that was all that was available, drank an occasional glass of wine because it was so stressful, ate chocolate in their sweet rolls because it was one of the decent things available to eat. I walked miles in hot weather, drank water like a camel because it was so dry and had many sleepless nights due to concerns over his condition and our situation--and I never missed a beat! I am convinced that there are "triggers" but that is not all there is to it; everyone is different and episodes are sometimes unexplainable! I admire your efforts and I am glad it works for you, but I would hate to have all those folks out there that think these changes will be the "cure" for their A-fib to be disappointed if they still have attacks of arrhythmia. My electrophysiologist calls it a crapshoot; all those changes may seem to work, but breakthroughs are often unexplained by any causal event/behavior. Good luck; I hope you stay well!